Histopathological considerations of transvaginally implanted polytetrafluoroethylene mesh in human biological tissues

Abstract

Polypropylene (PP) has been widely used as a mesh for the surgical treatment of pelvic organ prolapse (POP). However, PPs have been shown to cause complications, including tissue invasion, chronic pain, and infection; therefore, regulatory agencies deemed PP mesh was not inappropriate for use in transvaginal pelvic floor reconstruction surgery, which led to a recall of mesh products. In Japan, transvaginal mesh (TVM) surgery is still being performed using ORIHIME®, a Japanese mesh made of polytetrafluoroethylene (PTFE), which has been available since 2017. In this study, we performed each histopathological examination of tissue fragments collected from recurrent cases of TVM surgery using PP and PTFE meshes. Histopathological findings showed that PTFE had less fibrosis with the surrounding tissue than PP, and no extensive infiltrative extension of inflammatory changes was observed. These results suggest that PTFE may be one of the most suitable mesh materials for pelvic floor reconstruction.